Do I have Cancer or Not? and the Precancerous Cop Out

Mention someone with cancer in a discussion and anyone just joining the conversation will likely begin asking questions about who you are talking about, what sort of cancer they have and how serious it is. In contrast, an interrupted discussion about a benign tumor will first involve clarification about whether the tumor is cancerous, but will then move on to whether or not it causes problems. The difference is because most people understand the life-threatening implications of cancer.

However, there is a gray area between benign and cancerous tumors that is not as easy to understand. The labels precancerous and premalignant are equivalent terms that patients will hear from a doctor. Neither of these terms is particularly meaningful to patients as a diagnosis because we want to know whether or not we have cancer and these terms tend to cloud the understanding.

The term precancerous describes that state where a tumor has not yet shown the signs of aggressive growth, the tendency to kill surrounding tissues or the desire to travel to other parts of the body. On the basis of that description, however, you might wonder what the difference between a precancerous tumor and a benign tumor might be.

The distinction in definition is subtle to most people as it relates to the risk of the tumor becoming cancerous. A tumor that is labeled as benign is described that way because previous observations of other tumors of that type shows they rarely become cancerous. On the other hand, tumors labeled as precancerous have more frequently been observed to become cancer. Even true cancer cells that have not started to move or invade other tissues, called "cancer in situ", fall under the banner of precancerous.

To patients, the diagnosis of precancer ultimately means one of two things depending on the risks. For lower risk precancerous growths, doctors will often recommend "watchful waiting" with regular visits to the doctor whereas the recommendation for the higher risk growths involves treating them like you would any cancer.

Some typical forms of precancerous growths that often involve watchful waiting are colon polyps, bladder polyps, prostate tumors and some mouth sores. These involve watchful waiting because in many cases, the growths will not change to become dangerous.

As you can see, the whole definition of precancerous or premalignant is really an indication of the relative risks to your health of a tumor or growth. It is just unfortunate that there is not a better, more meaningful word to describe the condition. As humans, we readily grasp concepts described by extremes, but the trouble arises when we have to understand the subtleties in between.

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